SEX DIFFERENCES IN THE PREVALENCE OF FRAILTY IN A POPULATION AGED 75 AND OLDER IN SPAIN
Notice bibliographique
Résumé
To the Editor: In Spain, a country of 44 million people with a life expectancy of 83.5 for women and 77.0 for men, 17% of the population is aged 65 and older. We report here what, to our knowledge, are the first estimates of the prevalence of frailty in a Spanish population of community-dwelling persons. Data are from the fifth wave of "Aging in Leganés" a cohort of 1,699 persons aged 62 and older started in 1993 in Leganés, a city in the metropolitan area of Madrid.1 On September 1, 2006, there were 450 persons aged 75 and older still surviving who had participated in at least one of the preceding waves. Data were collected through personal home interviews and examinations in September to December 2006. Individuals were classified as "frail" when at least three of the five frailty criteria proposed previously2 were present. Information on education, marital status, comorbidity, and disability in activities of daily living (ADLs) was also collected.1 Logistic regressions were fitted to identify correlates of frailty and its five components. Prevalence of frailty was significantly higher in women (30.9%) than in men (9.3%) (P<.001). Women had a higher prevalence of exhaustion (35.6% vs 9.0%, P<.001), slow walking (57.4% vs 20.9%, P<.001), and low physical activity (39.3% vs 22.5%, P=.003) than men and a similar prevalence of weight loss (6.0% vs 9.3%, P=.31) and grip strength (31.0% vs 26.2%, P=.39). A sharp increase of frailty prevalence after age 85 was observed in men and women (Table 1). Controlling for age, education, comorbidity, and ADL disability, women's odds of frailty were 2.60 (95% confidence interval (CI)=1.13–5.98) compared with men. Women had higher odds of exhaustion (odds ratio (OR)=5.62, 95% CI=2.72–11.62) and slow walking (OR=5.51, 95% CI=3.05–7.46); there were no significant sex differences in low physical activity, weight loss, or grip strength. Prevalence of frailty in people aged 75 and older in Spain was higher than that reported in studies in comparable age groups in men and women,2–4 which is contrary to what could be expected given the high longevity of elderly people in Spain5 but consistent with previous work showing the higher prevalence of disability and lower disability-free life expectancy than other European populations.6,7 The higher frailty of women, even after adjustment for age, education, chronic diseases, and disability, is also puzzling given the 6.5-year sex gap in life expectancy in Spain. Two of the criteria that define the concept of frailty support this sex difference: slow walking speed and exhaustion. It was hypothesized that this excess frailty may be partly due to the marked sex roles still present in this age group of elderly people, for which most women were housewives with a clear domestic role, restrained social life, and little economic independence while men were the providers. We gratefully acknowledge the other members of the current "Aging in Leganés" research team. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. This research was supported in part by the FIS Programme (PI/95/1868 and RETICS 06/13/1013). Author Contributions: AO, VZ, and FB participated in the study concept and design. All authors were involved in analysis and interpretation of data and in preparation of the letter. Sponsor's Role: None.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».